Chinese expert consensus on transradial access in percutaneous peripheral interventions

Transradial access(TRA)is a safe and comfortable approach and the preferred access for percutaneous coronary intervention.However,TRA is not widely used for peripheral interventions.Currently,there is a lack of data on patient selection,appropriate medical devices,complication prevention,and TRA adoption.Therefore,the Chinese Society of Interventional Oncology of the China Anti-Cancer Association organized nationwide experts to establish a Working Group of China Expert Consensus on TRA in percutaneous peripheral interventions in 2022,and jointly formulated this consensus to better promote the application of TRA in peripheral interventions to guide clinicians on patient selection,technical recommendations,and physician training.This consensus mainly focuses on the current situation,advantages and limitations of TRA in peripheral interventions,anatomical characteristics of the radial artery,patient selection,technical aspects,prevention and management of complications,radiation dose,and learning curve.A consensus was reached through a literature evaluation and by referring to the opinions of the expert group.

A comparative study on transradial vs transfemoral artery access for primary percutaneous coronary intervention in patients with acute myocardial infarction

Objective Comparative study on the feasibility,safety and outcome of transradial artery and transfemoral artery access for primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction(AMI).Methods Two hundred and eight patients with AMI episoded within 12 hours, male 159, female 49, age 58.9 ±11.9 (34～88)years, were randomly divided into transradial artery access for primary PCI (TRA pPCI) group of 106 cases and transfemoral artery access for PCI (TFA pPCI) group of 102 cases during Sept, 2000 to Aug, 2002. The protocols of the manipulation duration and the effect for TRA pPCI and TFA pPCI procedures were respectively compared, including the time of transradial artery puncture and the rate of puncture success at first time ; the time of guiding catheter engaging into target coronary ostium; the rate of patence in infarct related artery (IRA); total duration of manipulation and the successful rate.The incidence of complications such as bleeding, vessel injury,thrombi and embolism as well as the average stay of hospitalization between two groups was compared. The status and the incidance of vessel spasm were observed and the effect of medicine administration to prevent from and relieve the vascular spasm was evaluated. The time of Allen’s test before and after TRA pPCI , the inner diameter and the peak of blood velocity of the right and left radial artery were investigated with color Doppler vessel echography as well as the complications of radial artery were followed up 1 month after TRA pPCI procedure. Results Two cases in every TRA pPCI and TFA pPCI groups were crossed over each other because procedure of the transradial or transfemoral access was failure. One handred and six vessels (48 vessels in LAD,22 vessels in LCX and 36 vessels in RCA) associated with 28 vessels of total occlusion in TRA pPCI group and 102 vessels (51 vessels in LAD,18 veesles in LCX and 33 vessels in RCA) with 24 vessels in total occlusion in TFA pPCI group were angioplasticized . The successful rates of the first time puncture in access artery, the re patence IRA and pPCI were similar in TRA pPCI and TFA pPCI groups ( 93.4% vs 96.1% ;100% vs 100%; 96.2% vs 97.1% , P >0.05 ). There were no significant diffierence in the average time of puncture time of access artery ,engaging in target vessels of guiding catheters and the total procedure of PCI between the two groups ( 1.3 ±0.3s vs 1.2 ±0.3s ; 6.0 ±1.6min vs 5.8 ±0.9min ; 49.2 ±24.1min vs 46.5 ± 26.4min , P >0.05 ). The access artery complications such as bleeding ,hematoma and embolism as well the veneous thrombosis in TFA pPCI group were much more than those in TRA pPCI group(p< 0.01 ). Although slight artery spasm of 4.7% cases in TRA pPCI group was happened during the procedure of PCI , the procedure had being continued after administration of medicine to release the spasm. The time of Allen’s test ,diameter and the systolic velocity of blood in daul radial arteries were no significant change before and after pPCI.Conclusions The duration and effect by TRA pPCI for AMI with stable hemodynamics was similar to TFA pPCI. The complications such as of bleeding,vessel injury, thrombi and embolism by TRA pPCI were few, and it was unnecessary to discontinue the anticoagulation medicine. TRA pPCI might be selected as a access vessel for pPCI in AMI patients with stable hemodynamics.

Feasibility analysis of coronary angiography by transradial approach with 4F catheter

Objective:To assess the feasibility of coronary angiography by transradial approach with 4F catheter.Methods:The procedural details,picture quality,local complication were recorded for coronary by transradial approach with 4F catheter in 138 patients.Results:The success rate of angiography was 97.7%;fluoroscopy time was(5.05±3.23)minutes,total procedural time was(20.51±3.37)minutes;the incidence of dislodgement,excessive engagement of either coronary artery was 7.8%,9.4%,repectively;the angiographic scores for left anterior descending,circumflex and right coronary arteries were(2.87±0.40),(2.88±0.39),(2.90±0.35),respectively.The spasm complication occurred 4.3% in radial artery and 1.5% in coronary artery.There were no occlusion of radial artery during follow up.Conclusion:4F catheter could be the first chosen in some selecting patients for its nice maneuverability,fine images and fewer vascular complications.

Transradial Versus Transfemoral Approach for Percutaneous Coronary Intervention in Elderly Patients in China： A Retrospective Analysis

Objective To compare hospital costs and clinical outcomes between transradial intervention （TRI） and transfemoral intervention （TFI） in elderly patients aged over 65 years. Methods We identified 1229 patients aged over 65 years who underwent percutaneous coronary intervention （PCI） in Fuwai Hospital, Beijing, China, between January 1 and December 31, 2010. Total hospital costs and in-hospital outcomes were compared between TRI and TFI. An inverse probability weighting （IPW） model was introduced to control potential biases. Results Patients who underwent TRI were younger, less often female, more likely to receive PCI for single-vessel lesions, and less likely to undergo the procedure for ostial lesions. TRI was associated with a cost saving of CNY7495 （95%CI： CNY4419-10 420）. Such differences were mainly driven by lower PCI-related costs. TRI patients had shorter length of stay （1.9 days, 95%CI： 1.1-2.7 days）, shorter post-procedural stay （0.7 days, 95%CI： 0.3-1.1 days）, and fewer major adverse cardiac events （adjusted odds ratio = 0.47, 95%CI： 0.31-0.73）. There was no statistical significance in the incidence of post-PCI bleeding between TRI and TFI （P〉0.05）. Such differences remained consistent in clinically relevant subgroups of acute myocardial infarction, acute coronary syndrome, and stable angina. Conclusion The use of TRI in patients aged over 65 years was associated with significantly reduced hospital costs and more favorable clinical outcomes.

A comparative study of TR Band and a new hemostatic compression device after transradial coronary catheterization

Objective: Transradial coronary catheterization has proved to be safe and effective in clinical practice. Various hemostatic compressive devices have been used in subsequent procedures. The objective of this study was to compare the efficacy and safety of a new hemostatic compression device and the widely used TR Band. Methods: A total of 118 patients were divided randomly into two groups: TR Band and the new hemostatic compression device. Efficacy of hemostasis, patient comfort, local vascular dysfunction, and radial artery occlusion(RAO) were evaluated and compared between groups. Results: Occurrence of errhysis or hematoma did not significantly differ between groups(13.6% vs. 11.9%, P = 0.782). Fewer patients had moderate to severe pain or moderate to severe numbness in the new hemostatic compression device group(1.7% vs. 22.0%; 1.7% vs. 18.6%, respectively). Pulse loss between distal artery and device was lower in the new hemostatic compression device group(5.1% vs. 22.0%, P = 0.007), and fewer patients experienced obstruction of venous reflux compared with the TR Band group(6.8% vs. 25.4%, P = 0.006). Combined incidence of RAO at discharge was 7.6%, and was lower in the new hemostatic compression device group(1.7% vs. 13.6%, P = 0.015). In contrast to the TR Band, application of the new hemostatic compression device was independently associated with lower incidence of RAO at discharge(odds ratio: 0.062, 95% confidence interval: 0.006–0.675, P = 0.022). Conclusions: Both the new hemostatic compression device and the TR Band can efficiently achieve hemostasis following transradial coronary catheterization. However, fewer patients felt discomfort with application of the new hemostatic compression device. Pulse loss in the artery distal to the compression device, obstruction of venous reflux, and RAO occurred significantly less often with application of the new device.

Comparison of very-high-frequency ultrasound assessment of radial arterial wall layers after first and repeated transradial coronary procedures

Background Transradial coronary procedure （TRP） traumatizes the radial artery （RA）, especially resulting in changes to arterial wall morphology. This study explored the significance of the early onset of traumatic effects to wall layers of the RA following the first TRP （FTRP） and repeat TRP （RTRP） using very-high-frequency ultrabiomicroscopy （VHFUBM）. Methods A total of 1431 patients that re- ceived TRP were divided into the FTRP group that comprised 781 patients and the RTRP group that comprised 650 patients depending on the number of procedures. Two-dimensional RA images were acquired by 30-55 MHz ultrasound one day before and one day after the pro- cedure. Results After TRP, the incidence of intimal tears, medial dissections and external elastic lamina fracture were greater in the RTRP （P 〈 0.001）. The RTRP group showed significantly thicker intimal thickness （IT）, media thickness （MT）, adventitia thickness and all complex layer thicknesses as compared with the FTRP group （P 〈 0.001）. Conclusions Multivariate linear regression analysis discovered that repeated TRP and other observations were independent predictors of increased IT in post-operative RA. VHFUBM provides an approach to study structural and histopathological injury in the wall layers of RA which showed increased trauma to the RA following RTRP.

Transradial versus transfemoral approach for cerebral angiography: A prospective comparison

Objectives: To evaluate the feasibility, efficiency, and safety of the transradial approach(TRA) for cerebral angiography versus the transfemoral approach(TFA) in patients.Methods: In this trial, 2314 patients underwent cerebral angiography, with 1085 patients undergoing the procedure via radial access and 1229 via transfemoral access. The arterial puncture time, operation success rate,oppression time on puncture points, local vascular complication incidence(including bleeding, hematoma, and pseudoaneurysm), deep venous thrombosis of lower limbs(DVT), and bradycardia/hypotension were observed and compared between the two groups.Results: Of the patients who underwent cerebral angiography via radial access, the procedure was successful in1070 patients;compared with 1219 patients with transfemoral access, there was no significant difference(P > 0.05) in the success rate or the arterial puncture time. Radial access patients were less likely to present with oppression time on puncture points, local vascular complications, DVT, and bradycardia/hypotension compared with femoral access patients.Conclusions: For patients undergoing cerebral angiography, radial and femoral approaches are both safe and effective. However, the lower rate of local vascular complications may be a reason to use the radial approach.

Safety and efficacy of transradial coronary angiography and intervention in patients older than 80 years： from the Korean Transradial Intervention Prospective Registry

Background Radial artery access for coronary procedures is a safe and beneficial technique. However, elderly patients have been considered as a higher risk group of access site related complications compared to younger patients. This study was conducted to investigate the feasibility and safety oftransradial coronary angiography or intervention in the elderly. Methods A total of 6132 patients from Korean Transradial Intervention Prospective Registry at 20 centers were analyzed. Patients were divided into the non-elderly group （n = 5667） and the elderly （_〉 80 years） group （n = 465）. Using propensity score matching, the elderly group （n = 465） was compared with one-to-one matched the non-elderly group （n = 465）. Results After propensity score matching, mean age was 64.3 ＋ 10.3 years in the non-elderly group and 83.5 -4- 3.3 years in the elderly group. There was no difference of procedural characteristics, procedural and fluoroscopic times. Access site cross-over rate was not different between the non-elderly group and elderly group （7.5% vs. 6.2%, P = 0.074）. Bleeding compli- cations occurred similarly in two groups （2.6% of the non-elderly group vs. 1.9% of the elderly group, P -~ 0.660）. Access site complications were 1.9% of the non-elderly group and 0.9% of the elderly group （P = 0.263）. Both of in hospital death and cardiovascular death for one year were also similar between two groups. Conclusions Transradial angiography or intervention was safe and feasible in elderly patients. Complication rates and clinical outcomes in elderly patients were comparable with those in non-elderly patients.

Effectiveness and feasibility of transradial approaches for primary percutaneous coronary intervention in patients with acute myocardial infarction

Objective： To evaluate the efficacy and feasibility of the transradial approach for primary percutaneous coronary intervention （PCI） in patients with acute myocardial infarction（AMI）. Methods： 195 patients with acute myocardial infarction were randomly divided into two groups according to the different PCI operation pathways. 105 cases were assigned to the transfemoral artery group and 90 cases to the transradial artery group. We analyzed the data from the two groups, including the achievement ratio of paracentesis, cannulation time, the time from local anesthesia to the first time balloon inflation, the time of the total procedure, achievement ratio of PCI, incidence rate of vascular complications, total duration of hospitalization, and the six-month follow-up results in both groups. Results： Our results showed that the achier ement ratio of arteriopuncture, cannulafion time and the time from local anesthesia to the first time balloon inflation in the transradial and transfemoral groups were 98.9% vs. 100%, 3.15 ± 1.56min vs. 2.86 ± 0.97 min, and 18.56 ± 4.37 min vs. 17.75 ± 3.21 min, respectively. These differences between the two groups were not statistically significant. The total operating time was 29.75 ± 4.38 rain for the transradial group and 27.89 ± 3.95 min（P 〈 0.05） for the transfemoral group. The operation achievement ratio in the transradial group was 96.7%, and 96.2% in the transfemoral group. The incidence of puncture point complications was 2.2% in the transradial group and 11.4% in the transfemoral group, and this difference was significant. The duration of hospitalization was 10.56 ± 2.85 days for the transradial group and 13.78 ± 3.15 days（P 〈 0.05） for the transfemoral group. At the six-month follow-up, the rate of survival without cardiac event was 86.1% vs. 86.4% respectively in the transradial and transfemoral groups（P 〉 0.05）. Conclusion： The transradial approach was as effective as the transfemoral approach, and there were fewer puncture point complications as well as a shorter span of hospitalization in the transradial group. PCI via the transradial approach is safe, effective and feasible in patients with AMI.

Hand dysfunction after transradial artery catheterization for coronary procedures

AIM To sythesize the available literature on hand dysfunction after transradial catheterization.METHODS We searched MEDLINE and EMBASE. The search results were reviewed by two independent judicators for studies that met the inclusion criteria and relevant reviews. We included studies that evaluated any transradial procedure and evaluated hand function outcomes post transradial procedure. There were no restrictions based on sample size. There was no restriction on method of assessing hand function which included disability, nerve damage, motor or sensory loss. There was no restriction based on language of study. Data was extracted, these results were narratively synthesized.RESULTS Out of 555 total studies 13 studies were finally included in review. A total of 3815 participants with mean age of 62.5 years were included in this review. A variety of methods were used to assess sensory and motor dysfunction of hand. Out of 13 studies included, only 3 studies reported nerve damage with a combined incidence of 0.16%, 5 studies reported sensory loss, tingling and numbness with a pooled incidence of 1.52%. Pain after transradial access was the most common form of hand dysfunction(6.67%) reported in 3 studies. The incidence of hand dysfunction defined as disability, grip strength change, power loss or any other hand complication was incredibly low at 0.26%. Although radial artery occlusion was not our primary end point for this review, it was observed in 2.41% of the participants in total of five studies included.CONCLUSION Hand dysfunction may occur post transradial catheterisation and majority of symptoms resolve without any clinical sequel.

Transradial versus transfemoral rotablation for heavily calcified coronary lesions in contemporary drug-eluting stent era

Background Although radial access for drug-eluting stent （DES） combined with rotational atherectomy （RA） in patients with calcified coronary lesions may be associated with a lower risk of major bleeding complications and obtain favorable clinical results compared with femoral access, the long-term outcome data of this approach were limited in contemporary DES era. Methods ＆ Results This retrospective study sought to compare in-hospital and long-term outcomes for patients undergoing RA via the transradial （TR） and transfemoral （TF） route in 126 consecutive patients （59 radial, 67 femoral） from 2009 to 2014. TR RA procedures were performed in 44/62 （71%） by the three TR operators, compared with 15/64 （23%） by the four TF operators in the present study. Significantly smaller diameter guide catheters and burrs （1.39 ± 0.16 mm vs. 1.53 ± 0.24 mm, P = 0.001） were used in the TR group. Procedural success rates were similar in both TR and TF groups. There was a significantly less major access site bleeding complications in favor of radial artery access （2% vs. 16%, P = 0.012）. The incidence of in-hospital death or myocardial infarction was low in both groups. Although a trend of lower adverse event rate was demonstrated in the TR group compared with the TF one, no statistical significance （21% vs. 27%, P = 0.135） was detected. Conclusions Radial access, a useful alternative to femoral access for RA and DES, can be safely and successfully performed on up to 71% of the patients with heavily calcified coronary lesions needing RA by experienced TR operators.

The Current State of Transradial Access:A Perspective on Transradial Outcomes,Learning Curves,and Same-Day Discharge

The adoption of transradial access in the United States and internationally has been growing over the past few years.In the population of patients presenting with acute coronary syndromes,particularly ST-elevation myocardial infarction,transradial access has the benefit of fewer vascular and bleeding complications and lower mortality rates over transfemoral access.We will examine the current evidence supporting transradial access for several patient populations,including those patients presenting with acute coronary syndromes.We will review the literature regarding the learning curve for transradial access with new operators,as well as experienced transfemoral operators new to transradial access.Finally,we will investigate the role of transradial access in same-day discharge for stable patients undergoing percutaneous coronary intervention.

The Transradial Approach for Cardiac Catheterization and Percutaneous Coronary Intervention:A Review

Cardiac catheterization and percutaneous coronary intervention play an important role in the management of coronary artery disease.Although the transfemoral approach has been the traditionally dominant method,there has been an increased utilization of the transradial approach.Multiple observational studies and randomized clinical trials have shown fewer bleeding complications,reduced morbidity and mortality,improved quality of life,and better economic outcomes when the transradial approach is utilized when compared to the transfemoral approach.Despite its many benefits,utilization of this approach in certain countries including the United States has been less than optimal due to a lower adoption rates mostly driven by lack of training opportunities and decreased awareness of clinical benefits of the transradial approach.In this review,the history,observational trends,efficacy,and technical aspects of transradial cardiac catheterization and percutaneous coronary intervention are discussed.

Comparison of transradial and transfemoral percutaneous coronary intervention in women:a propensity score matching-based analysis

Objective We conducted the present study in order to compare safety and efficacy of transradial intervention(TRI)and transfemoral intervention(TFI)in women undergoing percutaneous coronary intervention(PCI)in a large heart center in China.Methods The study population consisted of a consecutive cohort of 5,067 women undergoing PCI in Fuwai Hospital,Beijing,China between 2006 and 2011(TRI:n=4,105,TFI:n=962).

Topical anaesthesia before transradial approach for supraoartic vessels angiography and stenting in the elderly： a feasible alternative

Over the years, the use of transradial approach （TRA） for carotid artery stenting （CAS） with distal embolic protection has been recognized as a valid alternative to the conventional femoral approach, improving the outcomes compared to carotid endoatherectomy.0-33 Indeed, despite the femoral artery remains the conventional access site for the endovascular treatment of supraoartic vessels, concomitant anatomical variations and/or peripheral vascular disease could complicate the cannulation of such arteries. Moreover, the TRA has been related with a lower incidence of bleeding complications and a shorter bed rest after the interventional procedure.

Transradial approach for coronary procedures in the elderly population

Transradial cardiac catheterisation has been reported to be more beneficial compared to other approaches with easier and safer post-procedural haemostasis, better patient comfort, earlier ambulation and possibility of performing procedure and discharge on the same day. There is only limited data examining transradial access in the elderly population. In this review we looked at the available literature to give an insight into how the transradial approach compared to the transfemoral and other approaches in the elderly population. Elderly population is at higher risk of vascular access site bleeding and the transradial approach has shown equal efficacy to transfemoral approach. However, transradial approach significantly reduces vascular complications, hospital stay, mobilization times and adverse cardiac events. Therefore, transradial approach should be considered as the preferred vascular access site in the elderly population.

Transradial angiography procedure approach in with and without radial artery anomalies

Introduction: The transradial coronary angiography has several benefits such as the reducetion in access site complications especially in fully anticoagulated patients. The presence of arterial anomalies in upper limb arteries has an important role in procedural success. Methods: retrograde transarterial sheath injection was done in patients with transradial coronary angiography. Arterial anomalies in the upper limb evaluated. Cannulation time, the time of catheter passage to ascending aorta, and Angiographic time, were also meseared. Results: in 2011, 165 consecutive patients were studied, 116 (70.3%) male, age 56.7 ± 11.1 years. With 96.6% success rate in procedure, totally 59 anomolies were observed in 44 patients (26.7%). Radial artery by itself had ?25 anomalies (15.1%). The most frequent anomaly was abnormal origin of radial artery in 14 patients (8.5%) followed by tortuosities in 10 ulnar (6%). 9 brachial (5.4%), 7 radial (4/2%), 5 subclavian (3%) and 3 brachiocephalic arteries (1.8%). There also were 4 loops in ulnar artery (2.4%) and one in radial and brachinl arteries (each 0.6%). Other anomalies include 4 patients (2.4%), except cannulation time (p = 0.97), there were associations between anomalies and each of other times (p = 0.001) and contrast volume (p = 0.009). Anomalies didn’t have any effect on procedural success rate and just in one patient with sulclavian loop procedure changed to femoral approach (p = 0.19).

Performance of single reshaped Judkins left catheter for transradial coronary angiography

Background: To investigate the feasibility of single reshaped Judkins left catheter for transradial coronary angiography. Methods: A total of 198 consecutive patients were enrolled in the first step study. Patients were randomly assigned to brachial type catheter group (BRACT group) or Judkins left catheter group (Judkins group). The inclusion criterion was the left coronary angiography which could be accomplished by either a brachial type catheter or a reshaped Judkins left catheter. The successful procedure was defined as both right and left coronary angiography could be completed with a single reshaped Judkins left catheter or a brachial type catheter. Furthermore, 1873 consecutive patients were continuously enrolled to observe the success rate of single Judkins left catheter for transradial coronary angiography. Results: Of the 198 patients, 191 were finally enrolled in this study according to the inclusion criteria, with 95 patients in BRACT group and96 inJudkins group. There were no significant differences on baseline between the two groups. Procedure success rate was 84.10% with a fluoroscopic exposure time of 3.81 ± 0.43 min in BRA-CT group, and 81.60% with a fluoroscopic exposure time of 4.05 ± 0.48 min in Judkins group (P > 0.05). No severe complications were found in either of the two groups. The success rates of 1869 patients with single Judkins left catheter for transradial coronary angiography were 75.33%. There were no complications in those patients. Conclusions: Transradial coronary angiography with a reshaped single Judkins left catheter is feasible and practical, with an accepted procedure success rate. This method should be worthy of further clinical validation in a larger scale population.

The Systemic Inflammation on Transradial vs Transfemoral Approach for Coronary Angiography in Patients with Chronic Coronary Syndrome <br/>—Does Transradial Coronary Angiography Trigger More Inflammation?

Background: Most of the institutions accept the Transradial Access (TRA) as the first approach for patients undergoing Coronary Angiography (CAG) and Percutaneous Coronary Interventions (PCI). Several studies clearly revealed endothelial injury of coronary arteries triggers inflammatory response. In this study, we aimed to evaluate inflammatory respond to CAG and to compare the inflammatory response of TRA and Transfemoral Access (TFA). Methods: In this single-center prospective study 140 consecutive patients presenting with (Chronical Coronary Syndrome) CCS and underwent transradial or transfemoral CAG between December 2017 and December 2018 were included. After exclusions, left 92 patients were divided into two equal groups as TRA and TFA. The primary endpoints were 2nd hour Tumor Necrosis Factor alpha (TNFα), 48th hour high-sensitivity C-Reactive Protein (hs-CRP), complication rates, amount of contrast medium, procedure time and fluoroscopy time. Results: Basal characteristics of TRA and TFA groups were similar. A comparison of variables demonstrated that there was no statistical significance in increase in inflammatory markers (TNFα, hs-CRP), complication rates, amount of contrast media and procedure time. In contrast, TRA was associated longer fluoroscopy time and higher X-ray dosage, although statistically insignificant. CAG caused a similar increase in hs-CRP in both groups, insignificantly. Conclusion: In contrast to previous studies reporting a higher inflammatory response with TRA, this study demonstrates that inflammatory response caused by CAG is unrelated to access site and similar in TRA and TFA. Longer fluoroscopy time, higher X-ray dosage and longer procedure time in the TRA group indicate the importance of carefully selecting the angiographic route especially in patients with chronic heart failure, chronic renal impairment and malignancy risk. Also, these parameters place importance for physicians own health and woman planning pregnancy.

A novel role of chitosan in reducing vascular access bleeding complications after transradial angiography

To investigate the safety and efficacy of chitosan ( Anscare,Daxon) in reducing vascular ac cess complications compared to a kind of radial compression device( TR-BAND,Terumo) . Method: We studied 128 patients who had undergone transradial angiography in our center from December 2009 to April 2010. Among them,64 patients were randomly treated with radial compression device ( TR-BAND,Terumo) when the procedure was over ( CD group) . The other 64 patients were dealt with chitosan ( CS group) . The compression time,the major and minor access site bleeding complications and the errhysis were observed. Results: There were no statistical differences in the baseline clinical characteristics of the patients between two groups. The compression time in CS group was significantly shorter than that of CD group ( P < 0. 001) . There were 12 patients suffering from minor access site bleeding while only 3 patients experienced these minor complications in CS group( 19% vs 4% ,P < 0. 05) . At the same time 20 patients had er- rhysis in CD group and 4 patients in CS group ( 31% vs 6% ,P < 0. 001) . Conclusion: Chitosan,compared to radial compression device ( TR-BAND,Terumo) ,can not only shorten the compression time,but also significantly reduce the rate of minor access site bleeding and puncture-site errhyis.